The Association of Social Support and Loneliness with Symptoms of Depression, Anxiety, and Posttraumatic Stress during the COVID-19 Pandemic: A Meta-Analysis

Int J Environ Res Public Health. 2023 Feb 4;20(4):2765. doi: 10.3390/ijerph20042765.

Abstract

Background: Research suggests that changes in social support and loneliness have affected mental disorder symptoms during the COVID-19 pandemic. However, there are a lack of studies comparing the robustness of these associations.

Aims: The aims were to estimate the strength of the associations of loneliness and social support with symptoms of depression, anxiety, and posttraumatic stress during the COVID-19 pandemic (2020-2022) in the general population.

Method: The method entailed a systematic review and random-effects meta-analysis of quantitative studies.

Results: Seventy-three studies were included in the meta-analysis. The pooled correlations of the effect size of the association of loneliness with symptoms of depression, anxiety, and posttraumatic stress were 0.49, 0.40, and 0.38, respectively. The corresponding figures for social support were 0.29, 0.19, and 0.18, respectively. Subgroup analyses revealed that the strength of some associations could be influenced by the sociodemographic characteristics of the study samples, such as age, gender, region, and COVID-19 stringency index, and by methodological moderators, such as sample size, collection date, methodological quality, and the measurement scales.

Conclusions: Social support had a weak association with mental disorder symptoms during the COVID-19 pandemic while the association with loneliness was moderate. Strategies to address loneliness could be highly effective in reducing the impact of the pandemic on social relationships and mental health.

Keywords: COVID-19; anxiety symptoms; depressive symptoms; loneliness; posttraumatic stress symptoms; social support.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety
  • COVID-19*
  • Depression
  • Humans
  • Loneliness
  • Pandemics
  • Social Support
  • Stress Disorders, Post-Traumatic*

Grants and funding

Aina Gabarrell-Pascuet’s work is supported by the Secretariat of Universities and Research of the Generalitat de Catalunya and the European Social Fund (2021 FI_B 00839). Joan Domènech-Abella has a “Juan de la Cierva” research contract awarded by the ‘Ministerio de Ciencia, Innovación y Universidades’ (FJC2019-038955-I). Helena García-Mieres has a “Margarita Salas” research contract awarded by the University of Barcelona and financed by the Plan de Recuperación, Transformación y Resiliencia 2021-2023 of the Spanish government (NextGeneration EU funds).